ACT-UP, Patient Zero and the Manufacturing of Stigma

PUBHLTH 405
Social History of Infectious Disease
University of Michigan School of Public Health

Jon Zelner
[email protected]
epibayes.io

Agenda

  • Recapping Episode 6 of Fiasco (~10m)

  • Reading the original ‘Patient Zero’ analysis like it’s 1984 (~20m)

  • From Patient O \(\to\) Patient 0 (~45m)

Reading the original Patient ‘0’ analysis

We’re going to spend some quality time with this paper and pretend it’s still 1984

Patient 0 = “Outside” California

Dugas became a starring character in “And the Band Played On”

Worried that the mainstream media might not give coverage to Shilts’s popular history, his editor at St. Martin’s Press, Michael Denneny, approved a bold publicity strategy. He focused on Shilts’s identification of Dugas as “Patient Zero” and the flight attendant’s conflicts with physicians and public health officials, sensing that the salacious story the journalist had created would prove irresistible. (From (McKay 2014))

Conservative and mainstream media focus on him as a villain

His hunch was accurate: the New York Post’s headline on October 6, 1987, epitomized the media’s response and characterized the popular memory of Gaétan Dugas from that point on. “the man who gave us aids” read the front page, claiming that Dugas “triggered ‘gay cancer’ epidemic in U.S.”76 Other publications drew upon the frequently rehearsed narrative of a disease introduced from abroad by a foreigner. “Canadian Said to Have Had Key Role in Spread of AIDS,” wrote the New York Times, while the National Review nicknamed Dugas “the Columbus of AIDS.” (McKay 2014)

The narrative goes mainstream

60 Minutes, 1987

Dugas in his own words (1983)

From a documentary about the 1983 Vancouver AIDS conference

Genomic data have thoroughly debunked the ‘Patient 0’ idea about HIV

Map and phylogenetic tree of early HIV-1 sequences from (Worobey et al. 2016)

Nonetheless, the we are stuck with the concept…

Next Time

  • Fiasco Episodes 6 & 7

  • The emergence of robust AIDS activism

  • Arrival of effective anti-HIV drugs

References

McKay, Richard A. 2014. “Patient Zero: The Absence of a Patient’s View of the Early North American AIDS Epidemic.” Bulletin of the History of Medicine, 161–94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046389/.
Worobey, Michael, Thomas D. Watts, Richard A. McKay, Marc A. Suchard, Timothy Granade, Dirk E. Teuwen, Beryl A. Koblin, Walid Heneine, Philippe Lemey, and Harold W. Jaffe. 2016. “1970s and ‘Patient 0’ HIV-1 Genomes Illuminate Early HIV/AIDS History in North America.” Nature 539 (7627): 98–101. https://doi.org/10.1038/nature19827.